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: Part A: Opioid Use Disorder (OUD) Patient Centered Language Activity  The following is a portion

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:Part A: Opioid Use Disorder (OUD) Patient Centered Language Activity 

The following is a portion of an interview with a patient. Replace the highlighted words with more appropraite words and Complete the following 5-part activity. Please refer to the Patient Centered Language for Naloxone Discussion (Let’s Talk About Naloxone-It Saves Lives).

 

Have you abused prescription drugs? 

Have you overdosed as a result of drug use? 

Does your family ever feel bad about being around someone like you? 

Do your friends or relatives know or suspect you are a user? 

Is anyone else in your household an addict? 

Have you ever lost friends because you are a junkie? 

Have you ever lost a job because you can’t stay clean? 

Have you engaged in illegal activities in order to support your habit? 

Have you ever used dirty needles? 

Have you been treated as an outpatient for opioid replacement therapy? 

Part B: Patient Case Discussion 

Patient Case Scenario Part 1 

CC/HPI: LT is a 66 yo female who presents to the emergency room with a broken hip from a fall. After a total hip replacement (THR), she stays in the hospital for 2 days. On day 3, she is discharged home and her nurse provides her with the prescriptions listed below and an order for home physical therapy (PT) and occupational therapy (OT). Her nurse offers LT and her spouse the opportunity to ask any questions but they stated they had none. 

 LT and her spouse picked up the prescriptions from the pharmacy on the way home. They declined counseling from the pharmacist when offered. A follow-up appointment with her orthopedic surgeon/orthopedic physician assistant (PA) was scheduled for 4 weeks. PT and OT home care services were initiated the next day. 

Discharge Medications: 

Oxycodone 10 mg PO Q4-6 hours prn pain #180

Ibuprofen 800 mg PO Q6 hours #120

Acetaminophen 500 mg PO Q4 hours #180

Discussion Prompts for Part 1: 

1. Describe how each provider LT met, from time of admission to her return home, could have intervened to help reduce the risk of drug misuse from the time LT was admitted to the time she was discharged home. 

 

 

Patient Case Scenario Part 2

At her 1-month follow up appointment, LT continued to complain of pain, so she was prescribed another 30 days of pain medications. At the 2 month appointment, LT complains of continued pain to her provider (PA/NP/DO/MD*). The provider has 3 options: 

Write another prescription for a 30 day supply of pain medication
Order imaging of the area in pain
Recommend non pharmacologic pain management such as OT, PT, acupuncture etc.

*DO= Doctor of Osteopathy, MD= Doctor of Medicine

Discussion Prompt for Part 2

2. Compare and contrast potential risks and benefits of each of the provider options mentioned above. Describe any additional options that the provider could consider. 

 

 

Patient Case Scenario Part 3

The provider ordered additional imaging. During the scan, LT confided to the sonographer that she was having trouble coping with the pain without the prescription opioids. 

Discussion Prompts for Part 3

3. Describe what steps the sonographer can take at this time to assist LT. 

 

 

Patient Case Scenario Part 4

LT declined the purchase of Narcan when she was picking up her last opioid prescription.  She started to “borrow” pain medications from friends, who had leftover opioids from a previous surgery at home. She took extra pain medications prior to an outpatient appointment in the health system (ie. Outpatient rehabilitation, annual eye exam, dental cleaning etc.) because she was feeling anxious. In the waiting room, LT is now unarousable. 

Discussion Prompts for Part 4

4. Describe the steps the provider in the outpatient office should take to address this situation. 

5. Describe how appropriate medication disposal could have prevented this part of the scenario. 

SCIENCE
HEALTH SCIENCE
NURSING
NUR MISC

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